腔内治疗下肢动脉硬化闭塞症围术期严重并发症分析  

Perioperative complications in endovascular therapy of arteriosclerosis obliterans

作　　者：张艳[1] 李承志[1] 关敏[1] 张红[1] 王晓白[1] 

机构地区：[1]暨南大学附属第一医院介入与血管外科,广东广州510632

出　　处：《中国介入影像与治疗学》2013年第6期321-324,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家"十一五"科技支撑计划课题项目(2006038073024)

摘　　要：目的探讨下肢动脉硬化闭塞症(ASO)腔内治疗围术期严重并发症发生的原因及处理方法。方法回顾分析经腔内治疗的286例ASO患者(347条患肢)的资料,观察围术期出现的并发症情况及处理结果。根据患者年龄、手术时间、病变程度进行分组,统计各组患者并发症的发生率。结果本组手术成功率98.85%(343/347)。29例出现围术期并发症(29/286,10.14%);其中严重并发症9例,包括心力衰竭5例、肾衰竭4例;一般并发症20例,包括血管破裂出血9例、急性血栓形成2例、栓子脱落2例、假性动脉瘤1例、肢体过度灌注6例。年龄≥60岁、手术时间≥120min、病变累及长度≥10cm时,并发症发生率(12.12%、34.25%、12.36%)高于年龄<60岁、手术时间<120min、病变累及长度<10cm者(5.68%、1.88%、6.48%)。总体死亡率1.05%(3/286)。结论患者年龄、手术时间和病变程度直接影响腔内治疗ASO围术期并发症发生率。对腔内治疗ASO围术期并发症给予重视和及时、正规治疗,是减少不良事件的有效方法。Objective To analyze the impact factors and management of perioperative complications in endovascular treat-ment of arteriosclerosis obliterans （ASO）. Methods Totally 286 patients （347 limbs） with ASO who had taken endovascu-lar treatment were collected and retrospectively analyzed. Perioperative complications and the treatment outcome were ob-served. All patients were grouped according to age, operation time and the severity of lesions, respectively. The incidence of complications in different groups were statistically calculated. Results The total technical success rate was 98.85 （343/347）. Perioperative complications occurred in 29 patients （29/286, 10.14%）, including 9 serious （5 heart failure, 4 renal failure） and 20 general ones （9 vascular rupture, 2 acute thrombosis, 2 emboli dropping, 1 pseudoaneurysm, 6 limb hyperperfusion）. The complication rate in patients with age ≥ 60, operation time ≥ 120 min and lesion depth ≥ 10 cm （12.12 %, 34.25 %, 12.36 %） were higher than those in patients with age 〈60, operation time 〈120 min and lesion depth 〈10 cm （5.68%, 1.88%, 6.48%）. The mortality rate was 1.05% （3/286）. Conclusion Patient＇s age, operation time and lesion severity will directly affect the complication rate of endovascular treatment of ASO of lower limb. Keeping alert and timely treating of perioperative complications is effective to reduce adverse events.

关 键 词：闭塞性动脉硬化 腔内治疗 并发症 

分 类 号：R654.3[医药卫生—外科学]